The County Dept. I volunteer for has ALL 1st due paid crew engines ALS. The one I am an explorer for has all BLS, but most have at least 1 medic on them anyway. (we are ALS non-transport), but if a squad is 10-7 we can use the engine as ALS if there is no spare.

We are non-transporting BLS. Everyone is a minimum of EMT-D, and we can use the AED, Combitubes and Epi 1:1,000 for anaphylactic shock. To use the Epi we have to call the E.D. unless EMS is on scene also all the EMS units are ALS with most having two medics.

ALL

One of the departments that I am an explorer with has all in-house units (2 Engines, 1 Tower Ladder, 2 Ambulances, 1 Pickup)staffed as ALS along with the command vehicle having ALS supplies, and the utility vehicle having a jump bag for ALS. Paramedic transport agency with fire first response if the bus' aren't available.

Other department runs 4 out of 4 engines as ALS first response with the local college being transport agency until July when we get the 2 new ambulances. Also added to that is 2 "Cars" which can also respond if all 4 engines are out, the aerial is out, and if the chief is already responding to a call.

A different department I use to run with had Full time EMS provided through a different town (gave them 1 unit to have in their town, kept one in it's own), used to respond as first response BLS on the 1st due engine or rescue depending on the crew that was there.

My department has quite a few ALS Suppression units, and our goal is to be all ALS by 2010. About four or five trucks are converted to ALS per year, and at our current rate, we will definitely meet our goal. The ALS suppression trucks have a minimum of two medics (Officer and Tailboard), and our Rescues are staffed with three medics. We were the first department in the US to place Retavase on an ALS Engine.